Different Access Areas, Access Techiques and Trocar Types in Transperitoneal Laparoscopy


  • Murat Bozkurt
  • A. Ender Yumru

Turk J Obstet Gynecol 2013;10(2):59-66

Laparoscopy has enabled a radical change of practice for surgeons over the last two decades. In general, laparoscopic surgery leads to less scarring, less postoperative pain and more rapid healing rates compared to laparotomy (1,2). Data are also available indicating that laparoscopic surgery has lesser complication rates compared to laparotomic surgery (3, 4). Although laparoscopic surgery is relatively safe, its causes unwanted and severe intestinal, bladder and vascular injury, requiring complicated equipment and a long learning curve limit is required for surgeons to master its use (5, 6). Most of the severe complications are related to trocar insertion (7,8). Developing equipments and technologies such as endoscopic threaded imaging port (EndoTIP), radial and ultrasonic wave transmitter trocars, the gradual development of single port applications besides conventional access areas and access techniques have been presented as possible approaches to counter these complications.

Laparoscopic access may be applied transperitoneally or retroperitoneally, depending on the branch undertaking laparoscopy and the nature of the planned operation. In this review, transperitoneal access techniques, possible access areas and the advantages and disadvantages of various trocars frequently used by obstetricians in the course of this type of access were analyzed.

Keywords: Laparoscopy, entry techniques, trocar types